Beyond ‘brain fog’ – cognitive dysfunction in lupus patients

2 minute read

PODCAST Join Associate Professor Alberta Hoi and Dr Sudha Raghunath as they discuss the real penalty of cognitive dysfunction in lupus and what to do about it.

Amid the myriad lupus symptoms, it’s not difficult to overlook cognitive dysfunction. But Australian researchers have identified that the issue is a bigger problem than expected. 

Associate Professor Alberta Hoi and Dr Sudha Raghunath join us for this episode of In Conversation podcast and share their research. 

Dr Raghunath said that cognitive dysfunction scores are widespread in lupus patients and many with serious levels of impairment. 

“It’s not a homogenous disorder, it’s really heterogeneous because there are lots of different factors that can contribute, and I feel as though there’s lots of different phenotypes within this patient group,” she said.  

Although Dr Raghunath’s research revealed widely divergent cognitive dysfunction results, the most commonly affected cognitive domains were attention, working memory and executive function. Performance on tests of language reasoning and motor speed seem to be less affected.  

Yet many patients also found effective management strategies to deal with sometimes seriously impairing symptoms. 

“My initial clinical impression of these women was that they were actually pretty intact cognitively. And then when I did the assessments, I was really surprised to find that some of these young women performed quite poorly on cognitive tests. It made me reflect on how I was looking after them clinically,” Dr Raghunath said. 

“Are they remembering to take the medications? Should I be providing more written information for certain patients?”  

Professor Hoi said that a lack of screening for cognitive dysfunction is exacerbated by patients’ perceptions of their own cognitive function.  

“What the patient reports in terms of their own symptoms may or may not correlate with their actual cognitive performance when we objectively test them,” she said.  

Other barriers include doctors prioritising more commonly understood symptoms and the complexity of neurological testing. 

There is, however, a solution to the testing barrier. Professor Hoi and Dr Raghunath found the Montreal Cognitive Assessment (MoCA), test for early detection of mild cognitive impairment to be very useful in the lupus population. 

The MoCA test is something very simple that clinicians can do during consultations to start discussions about what the patient is experiencing and whether they have any objective abnormalities,” Associate Professor Hoi said. 

See more on the MoCA test here: 

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